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Executive SummaryIntroductionExplore the Health of Women, Children and InfantsFindingsThe Health of Women and Children between StatesThe Health of Women and Children within StatesHealthy Communities for ChildrenClinical Preventive Services for ChildrenRacial Disparities in Measures of MortalityVariations in SmokingMeasures of Women's HealthBehaviors | Measures of Women’s HealthCommunity & Environment | Measures of Women’s HealthPolicy | Measures of Women’s HealthClinical Care | Measures of Women’s HealthOutcomes | Measures of Women’s HealthMeasures of Infants' HealthBehaviors | Measures of Infants’ HealthCommunity & Environment | Measures of Infants’ HealthPolicy | Measures of Infants’ HealthClinical Care | Measures of Infants’ HealthOutcomes | Measures of Infants’ HealthMeasures of Children's HealthBehaviors | Measures of Children’s HealthCommunity & Environment | Measures of Children’s HealthPolicy | Measures of Children’s HealthClinical Care | Measures of Children’s HealthOutcomes | Measures of Children’s HealthState SummariesAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingDistrict of ColumbiaUnited StatesAppendixData Sources and Measures of Women’s HealthData Sources and Measures of Infants’ HealthData Sources and Measures of Children’s HealthMethodologyModel DevelopmentAmerica’s Health Rankings® Health of Women and Children Steering GroupThe Team
Low-Risk Cesarean Delivery
Nearly one-third of US births are delivered by cesarean section each year. Women delivering singleton, term (37 or more weeks gestation), vertex (non-breech), first births are considered low-risk. The low-risk cesarean delivery rate increased from a low of 18.4% in 1997 to a high of 28.1% in 2009. Great variation in the cesarean delivery rates among hospitals nationwide indicates that differences in practice patterns are likely the driving force behind overuse of this delivery method. Increased use of cesarean delivery is associated with a rise in maternal morbidity. Adverse outcomes and complications from overuse of cesarean delivery have substantial cost implications for health insurers, providers, and the government.
Percentage of singleton, term (37 or more weeks gestation), vertex (non-breech) cesarean deliveries to women having their first birth per 100 women delivering singleton, term, vertex, first births
Prenatal Care Before 3rd Trimester
Adequate prenatal care is an important determinant of maternal and fetal health. Prenatal care is more likely to be effective if women begin receiving it in the first trimester of pregnancy, with continued receipt of care throughout pregnancy. Regular prenatal care reduces the risk of pregnancy and delivery complications and reduces infant’s risk of sudden infant death syndrome, neural tube defects, and fetal alcohol spectrum disorders. Inadequate care increases the risk of adverse birth outcomes, including preterm birth, low birthweight, stillbirth, early neonatal death, late neonatal death, and infant death.
Percentage of live births in which the mother received prenatal care before the 3rd trimester
* States using the 1998 US Standard Certificate of Live Birth and those missing 10% or more of data were excluded. The calculated US value may not represent the true US value.
Well-Baby Check
Well-baby visits provide an opportunity for preventing illness, tracking growth and development, discussing parent concerns, and developing a strong provider-patient relationship. These visits typically include measurement, sensory screening, developmental/behavioral assessment, physical examination, and certain other procedures (immunization, screenings) depending on age and risk. They are also an opportunity for providers to screen mothers for postpartum depression. Attendance at well-baby visits is associated with better continuity of care and fewer emergency department visits during childhood. The American Academy of Pediatrics recommends eight periodic preventive checkups for infants in their first year.